PART 1-5

INSTRUCTION: Select the correct answer for each of the following questions.
Mark only one answer for each item by shading the box corresponding to the
letter of your choice on the answer sheet provided. STRICTLY NO ERASURES
ALLOWED.

MULTIPLE CHOICE:

1.) Determine the number of dots that should appear on a manual spin top test
imaged for a single phase half-wave unit with an exposure of 500 milliseconds,
200 mA and 70 kVp.
A. 50 dots C. 60 dots
B. 30 dots D. 70 dots

Given:
 Half wave = 60 pulses/sec
 Time = 500 ms or 0.5 s
 dots = ?
Formula: dots = pulse/s x time
Solution:
 dots = 60 pulses/s x 0.5 s
 dots = 30 dots

2.) Spinning top test is performed to determine the accuracy of exposure timer of a
portable and dental x-ray imaging system (self-rectified). How many dots will
appear on the image if the exposure is made with 500 milliseconds, 50 kVp and
300 mA?
A. 50 dots C. 60 dots
B. 30 dots D. 70 dots

Given:
 Self rectified = 60 pulses/sec (same principle as half wave)
 Time = 500 ms or 0.5 s
 dots = ?
Formula: dots = pulse/s x time
Solution:
 dots = 60 pulses/s x 0.5 s
 dots = 30 dots

3.) Determine the number of dots that should appear on a manual spin top test
imaged for a full-wave rectified unit produced with an exposure of 200
milliseconds, 500 mA and 60 kVp.
A. 12 dots C. 72 dots
B. 24 dots D. 144 dots
Given:
 Fullwave = 120 pulses/sec
 Time = 200 ms or 0.2 s
 dots = ?
Formula: dots = pulse/s x time
Solution:
 dots = 120 pulses/s x 0.2 s
 dots = 24 dots

4.) If a manual spin top test film that imaged 12 dots was taken on a properly
functioning single-phase full wave rectified unit, what timer setting was employed?
A. 50 ms C. 150 ms
B. 100 ms D. 200 ms

Given:
 full wave = 120 pulses/sec
 dots = 12
 Time = ?
Original Formula: dots = pulse/s x time
Derived Formula: Time = dots ÷ pulse/s
Solution:
 Time = 12 ÷ 120 pulse/s
 Time = 0.1 s or 100 ms

5.) LET is another method of expressing radiation _____:

A. Absorbed dose C. Quantity
B. Exposure D. Quality

Bushong p.513 9th edition

6.) This is the dose of radiation to the whole body that causes 50% of irradiated
subjects to die within 60 days:
A. LD60/50 C. LD50/60
B. D60/50 D. D50/60

Bushong p.537

7.) This is the gonad dose that, if received by every member of the population,
would produce the total genetic effect on the population as the sum of the
individual doses actually received:
A. RBE C. OER
B. GSD D. LET

RBE (Relative Biologic Effectiveness)

 Ratio of the dose of standard radiation necessary to produce a given
effect to the dose of test radiation needed for the same effect
 X-ray: RBE = 1
 Low LET radiation: RBE = <1
  High LET radiation: RBE = >1

OER (Oxygen Enhancement Ratio)

 Ratio of the dose necessary to produce a given effect under anoxic
conditions to the dose necessary to produce the same effect under aerobic
conditions
 Designed to measure the magnitude of the oxygen effect

LET (Linear Energy Transfer)

 A measure of the rate at which energy is transferred from ionizing radiation
to soft tissue
 Another Method of:
o Expressing radiation quality
o Determining the value of the radiation weighting factor (WR)
 Used in radiation protection
 Expressed in: keV/μm
 Diagnostic X-rays: 3 keV/μm
 As LET Increases:
o Increases the ability to produce biologic damage
o Increases the probability of interaction with the target molecule

8.) Testes are reproductive organs of a/an:

A. Young adult C. Young man
B. Old adult D. Old woman

9.) Ovaries are reproductive organs of a/an:

A. Old woman C. Young adult
B. Old adult D. Old man

10.) Focal –spot sizes used in angiointerventional procedures or magnification

radiography:
A. 0.1 mm/0.3 mm C. 0.6 mm/1.2 mm
B. 0.5 mm/1.0 mm D. 0.3 mm/1.0 mm

Bushong p.248

11.) Focal –spot sizes used in most mammographic x-ray tubes:

A. 0.1 mm/0.3 mm C. 1.0 mm/2.0 mm
B. 0.5 mm/1.0 mm D. 0.3 mm/1.0 mm

Bushong p.248

12.) Focal –spot sizes used in conventional x-ray tubes:

1.) 0.6 mm/1.2 mm
2.) 0.5 mm/1.0 mm
3.) 1.0 mm/2.0 mm
4.) 0.3 mm/1.0 mm
A. 1 and 2 only C. 1, 2 and 3 only
B. 3 and 4 only D. 1, 2, 3 and 4
 Bushong p.248

13.) There are 100 turns on the primary side of the transformer and 60,000 turns on
the secondary side. If 110 V AC is supplied to the primary winding, what is the
voltage induced in the secondary winding?
A. 6,600 volts C. 66 kV
B. 660 volts D. 66,000 kV

Given:
 Np = 100 turns
 Ns = 60,000 turns
 Vp = 110 volts
 Vs = ?
Original Formula: Vs/Vp = Ns/Np
Derived Formula: Vs = Vp (Ns/Np)
Solution:
 Vs = 110(60,000/100)
 Vs = 110(600)
 Vs = 66,000 volts or 66 kV

14.) The primary side of a filament transformer has 1000 turns and 225 turns on
the secondary side. What is the filament current if the current through the primary
winding is 4 A?
A. 14 A C. 19 A
B. 16 A D. 18 A

Given:
 Np = 1000 turns
 Ns = 225 turns
 Ip = 4 A
 Is = ?
Original Formula: Is/Ip = Np/Ns
Derived Formula: Is = Ip (Np/Ns)
Solution:
 Is = 4(1000/225)
 Is = 4(4.44)
 Is = 17.77 A or 18 A

15.) The most efficient and most currently used type of transformer:
A. Autotransformer C. Shell-type
B. High voltage transformer D. Closed-core

Closed-core
 A square core of ferromagnetic materials built up of laminated layers of iron
 Reduced energy losses caused by eddy current
 Result: greater efficiency

Autotransformer
 Consists of one winding and one core
  Step up transformer
 Located in the operating console
o controls the kVp
 Receives the power supplied to the x-ray imaging system

Shell-type transformer
 Has two-closed core
 Confines more of the magnet field lines
 More efficient than closed-core
 Most currently used transformer

High voltage transformer

 Supplies voltage to the x-ray tube
 Step up transformer

16.) This type of x-rays has precisely fixed/discrete energies and forms a discrete
emission spectrum:
A. Ga mma C. Bremsstrahlung
B. Characteristic D. X-rays

Characteristic x-rays (Bushong p.144)

 Have precisely fixed/discrete energies
 Form a discrete emission spectrum

Bremsstrahlung x-rays (Bushong p.145)

 Have a range of energies
 Form a continuous emission spectrum

17.) Loss of contrast caused by internal scatter radiation in the image-intensifier

tube:
A. Vignetting C. Penumbra
B. Veiling glare D. Vidicon

Vignetting
 Reduction in brightness at the periphery of the image

Penumbra
 Image blur that results from the size of the focal spot
 Geometric unsharpness
 Halo effect

Vidicon
 A television camera tube
 Used most often in television fluoroscopy

18.) A backup timer for the AEC serves to:

1.) Protect the patient from overexposure
2.) Protect the x-ray tube from excessive heat
3.) Increase or decrease master density
 A. 1 only C. 2 and 3 only
B. 1 and 2 only D. 1, 2 and 3

19.) When the radiographer selects kilovoltage on the control panel, which device
is adjusted?
A. Step up transformer C. Filament circuit
B. Autotransformer D. Rectifier circuit

Rationale:
 When kilovoltage is selected on the control panel, the radiographer is
actually adjusting the autotransformer and selecting the amount of
voltage to send to the high voltage transformer to be stepped up (to
kilovoltage)

Step up transformer
 Has a turns ratio greater than 1
 Ns>Np
 Vs>Vp
 Is<Ip

Filament circuit
 Supplies the proper current and voltage to the x-ray tube filament for proper
thermionic emission

Rectifier circuit
 Responsible for changing AC to DC

20.) What is the thickness of the phosphor in the intensifying screen?

A. 50 mg/cm2 C. 60 mg/cm2
B. 50 mg/cm3 D. 60 mg/cm3

21.) What electronic technique is widely used for patient exposure control?
A. Automatic Exposure Control
B. Anatomically Programmed Radiography
C. Back up timer
D. mAs timer

Anatomically Programmed Radiography (Bushong p.265)

 A widely used electronic technique for patient exposure control
 RT does not select a desired kVp and mAs
 Graphics on console guide the RT

Automatic Exposure Control (AEC) – Bushong p.108

 A device that measures the quantity of radiation that reaches the image
receptor
 Terminates the exposure when the image receptor has received the required
radiation intensity

Back up timer
  Terminates the exposure when the automatic exposure control malfunctions
to prevent overexposure and tube overload

mAs timer
 Monitors the product of mA and exposure time
 Terminates the exposure when the desired mAs value is attained

22.) If an automatic exposure control malfunctions, overexposure and tube

overload is terminated by:
A. mAs timer C. Synchronous timer
B. Back up timer D. Electronic timer

Synchonous timer
 Used a synchronous motor
 Cannot be used for serial exposures
o Rationale: must be reset after each exposure

Electronic timer
 Most complicated, sophisticated and accurate exposure timer
 Mostly used timers
 Can be used for rapid serial exposure
 Controlled by microprocessors

23.) What system in the automatic processor consumed a large amount of

electricity?
A. Transport System C. Drying System
B. Replenishment System D. Developing system

Drying system
 Final process
 Removes 85-90% of moisture from the film so that it can be handle easily
and stored while maintaining quality of the diagnostic image
 10-15% remaining
 Consuming more electricity (60-80% electrical consumption)
 Rationale:
o Filament = 1500-2500 W
o Air blower = 100-300 cu-ft/min

24.) If kVp is decreased by 15%, the blackening of the film is reduced to

approximately:
A. 30% C. 40%
B. 50% D. 60%

Fifteen Percent Rule

 15% decreased in kVp is accompanied by doubling the mAs
o Rationale: OD is reduced by half (50%)

25.) How many percent must be changed to the mAs value to produce a perceptible
change in OD?
A. 4% C. 15%
 B. 30% D. 50%

Bushong p.254

26.) The first automatic film processor was introduced by:

A. Eastman Kodak C. Konica
B. Circa D. Pako

Pako
 Introduced the first automatic film processor (Circa 1942)

Eastman Kodak
 Introduced the first roller transport system (Circa 1956)
 Introduced the 90-second rapid processing (1965)

Konica
 Introduced the 45-second rapid processing

27.) How many percent must be changed to the kVp value to produce a perceptible
change in OD?
A. 4% C. 15%
B. 30% D. 50%

Bushong p.254

28.) Which of the following factors influence contrast?

1.) kVp
2.) Grid ratio
3.) Beam restriction
4.) mAs
A. 1 and 3 only C. 1, 2 and 3
B. 1 and 2 only D. 1, 2, 3 and 4

Bushong p.258 Table 15-10

Exposure Technique Factors That May Affect Radiographic Contrast

Results in the following change in
An increase in this factor
contrast
Kilovoltage Decrease
Grid ratio Increase
Beam restriction Increase
Image receptor used Variable
Development time Decrease
mAs Decrease (toe, shoulder)

29.) A 15% increase in kVp accompanied by a 50% decrease of mAs will result in
a:
1.) Long scale of contrast
2.) Low contrast
3.) Less contrast
4.) Wide exposure latitude
 A. 1 and 4 only C. 1, 2 and 3
C. 2 and 3 only D. 1, 2, 3 and 4

Bushong p.258

High kVp Low kVp

Long scale of contrast Short scale of contrast
Low contrast High contrast
Less contrast More contrast
Wide latitude Narrow latitude

30.) The exposure is made using 70 kVp and 4 mAs which produced a radiograph
with high density. To produce a comparable radiograph, what exposure technique
will be used for repeat exposure?
A. 66 kVp and 5 mAs C. 74 kVp and 3 mAs
B. 75 kVp and 2 mAs D. 81 kVp and 1 mAs

5% kVp Rule
 Increase the kVp to 5% and decrease the mAs to 30%
o Rationale: the density on the original exposure is high, therefore mAs
must be reduced, not the kVp
 Original Factors: 70 kVp and 4 mAs
 5% increased in kVp:
o 70 kVp x 0.05 = 3.5 kVp
o 70 kVp + 3.5 kVp = 73.5 kVp or 74 kVp (New kVp)
 30% decreased in mAs:
o 4 mAs x 0.3 = 1.2 mAs
o 4 mAs – 1.2 mAs = 2.8 mAs or 3 mAs (New mAs)
 New Technical Factors: 74 kVp and 3 mAs

31.) If you decrease the kVp to 15% of the original value, what will be the effect
on the finished radiograph?
1.) Short scale contrast
2.) High contrast
3.) More contrast
4.) Narrow latitude
A. 1 and 4 only C. 1, 2 and 3 only
B. 2 and 3 only D. 1, 2, 3 and 4

Bushong p.258

High kVp Low kVp

Long scale of contrast Short scale of contrast
Low contrast High contrast
Less contrast More contrast
Wide latitude Narrow latitude

32.) A 16:1 parallel grid is positioned for chest radiography at 180 cm SID. What
is the distance from the central axis to complete grid cutoff?
 A. 0.09 cm C. 11.3 cm
B. 8.89 cm D. 0.1125 cm

Given:
 Grid ratio = 16:1
 SID = 180 cm
Formula: Grid cutoff distance = SID/grid ratio
Solution:
 Grid cutoff distance = 180 cm/16
 Grid cutoff distance = 11.25 cm or 11.3 cm

33.) The filter used in chest radiography that permits visualization of dense
mediastinal structures without overexposing radiolucent lung and pulmonary
vascular markings:
A. Step wedge filter C. Trough filter
B. Bowtie filter D. Wedge filter

Trough filter
 Bilateral wedge filter
 Used in chest radiograph

Compensating filter
 Used to compensate for differences in thickness of the body part
 Helps produce uniform x-ray intensity

Step wedge filter

 Adaptation of wedge filter
 Used in some special procedure
o Serial radiography of abdomen and lower extremities

Bowtie filter
 Used in CT
 To compensate for the shape of the head or body

Wedge filter
 Used during radiography of foot

34.) Acidifier in fixer solution of the automatic processor:

A. Acetic acid and sulfuric acid
B. Sodium bicarbonate and potassium bicarbonate
C. Sodium hydroxide and potassium hydroxide
D. Phenidone and hydroquinone

Acidifier/Buffering Agents/Activator/Neutralizer (Fixer)

 Acetic acid/sulfuric acid
 Provides an acid medium and neutralized the developer carried over on the
film

Alkalinizer/Buffering Agent/Activator/Accelerator/Wetting Agent (Developer)

 Sodium hydroxide/bicarbonate & Potassium hydroxide/bicarbonate
  Maintain alkalinity
 Provides necessary alkaline medium
 Swells gelatin emulsion so that reducing agents can attack AgBr crystals

Phenidone and Hydroquinone

 Reducing agents in the developer solution

35.) The repeat rate of the films is determined by:

A. Dividing the rejected films by the total number of films then multiplied
by 100
B. Dividing the total number of films by the rejected films then multiplied
by 100
C. Dividing the number of repeated films by the total number of films
then multiplied by 100
D. Dividing the total number of films by the number of repeated films then
multiplied by 100

Bushong p.342

Repeat Analysis
 Repeat Rate (%) = (number of repeated films/total number of films) x 100
 Overall repeat rate: should not be <2%
 All repeated films should be included in the analysis not only those rejected
by the radiologists

36.) Poor screen-film contact results in loss of:

A. Density C. Contrast
B. Image D. Detail

Poor screen-film contact

 Blurry image (loss of detail)
 Common cause: foreign matter under the skin
 Wire Mesh Test: used to evaluate proper screen-film contact

37.) In Maslow Hierarchy of Needs, which of the following is the most important?
A. Self-actualization C. Self-esteem
B. Love/belonging D. Physiological

Maslow Hierarchy of Needs

(Abraham Maslow)
38.) In 5 Stages of Loss and Grief, what is the first stage experienced by people?
A. Anger C. Denial
B. Bargaining D. Depression

5 Stages of Loss and Grief (Kubler Ross)

 1st stage – Denial/Isolation
 2nd stage – Anger
 3rd stage – Bargaining
 4th stage – Depression
 5th stage – Acceptance

39.) An inherent defect in the structure of silver halide crystals consists of

interstitial silver ions and silver ion vacancies:
A. Point defect C. Sensitivity speck
B. Latent image center D. Frankel defect

Point defect
 Occurs when silver ions moves out from the crystal lattice

Latent image center

 Refers to sensitivity center that has many silver ions attracted to it

Sensitivity speck/center
 Physical imperfections in the lattice of the emulsion layer that occur during
the film manufacturing process

40.) Color of chemical stain on the radiograph:

1.) Yellow
2.) Blue
3.) Green
4.) Purple
A. 1 and 2 only C. 1, 2 and 3 only
B. 3 and 4 only D. 1, 2, 3 and 4

Bushong p.300

41.) The strongest alkali compound which is commonly known as lye and can
cause skin burn:
A. Sodium carbonate C. Potassium iodide
B. Sodium hydroxide D. Potassium bromide

Bushong p.197
Sodium carbonate
 Activator in the developer solution
 Helps swell gelatin
 Produces alkalinity
 Controls pH

Potassium iodide/bromide
 Restrainer in the developer solution
  Antifog agent
 Protects unexposed crystals from chemical attack

42.) In demonstrating the petromastoid portion of the skull using Law Method
(Part Angulation Method), how the head is positioned?
A. Head is rotated 15o away from the IR and tilted 15o from vertical
B. Head is rotated 15o toward the IR and tilted 15o from vertical
C. Head is rotated 15o away from the IR and tilted 15o from horizontal
D. Head is rotated 15o toward the IR and tilted 15o from horizontal

43.) Demonstration of the posterior fat pad on the lateral projection of the adult
elbow can be caused by:
1.) Trauma or other pathology
2.) Greater than 90o flexion
3.) Less than 90o flexion
A. 1 only
B. 2 only
C. 1 and 2 only
D. 1 and 3 only

44.) Which of the following methods require a 45o angulation of the head?
1.) Mayer
2.) Modified Law
3.) Arcelin
4.) Stenvers
A. 1, 2 and 3 only
B. 2, 3 and 4 only
C. 1, 3 and 4 only
D. 1, 2, 3 and 4
MAYER METHOD (Axiolateral Oblique Projection)
 MSP 45o; IOML parallel to IR
 RP dependent EAM
 CR 45o caudad
 Axial oblique of petrosa

LAW METHOD (Axiolateral Projection)

 MSP 15o;
 RP 2 in. posterior and 2 in. superior to uppermost EAM
 CR 15o caudad
 Mastoid

ARCELIN METHOD
 Anterior profile position
 Reverse Stenvers Method
 IOML perpendicular; MSP 45o
 RP 1 in. anterior & ¾ in. superior to EAM closest to IR (exit)
 CR 10o caudad
 Magnified pars petrosa away from IR
  Useful with children & with adults who cannot be position for Stenvers
Method

STENVERS METHOD
 Posterior profile position
 Forehead, nose & zygoma (3-pt Upper Landing)
 IOML parallel to transverse axis of IR
 MSP 45o
 RP 1 in. anterior to EAM closest to IR
 CR 12o cephalad
 Pars petrosa closest to IR

45.) If the patient’s head cannot be adjusted to place the IOML nearly parallel to
the IR, what is the alternative way to obtain good SMV projection radiograph?
A. Place the OML parallel to IR
B. Place the CR parallel to IOML
C. Place the CR perpendicular to IOML
D. Place the CR perpendicular to OML

46.) This projection/method is useful in demonstrating the anterior cranial base and
sphenoid sinuses in which the IR is place in contact with the throat to reduce the
magnification and distortion of the structures:
A. Water’s C. SMV
B. Caldwell D. VSM

Verticosubmental Projection
 Distorted & magnified basal structures
 Useful for anterior cranial base & sphenoidal sinuses
o IR in contact with the throat
o Reduces magnification & distortion

47.) In oblique projection of the foot, how many degrees of rotation are required?
A. 15o C. 20o
B. 30o D. 45o

48.) What projection is used to demonstrate true lateral projection of the foot?
A. Lateral C. Lateromedial
B. Mediolateral – for patient comfort D. Translateral

49.) In Camp-Coventry Method, how many degrees of knee flexion are required to
demonstrate the intercondylar fossa?
A. 20-30o C. 40-50o
B. <10o D. 60-70o

20-30o
 For lateral projection of the knee
 To relax the muscles

<10o
 For lateral projection of the knee
  For new or unhealed patellar fractures

60-70o
 Holmblad method

50.) The coronoid process should be visualized in profile in which of the following
positions?
A. Scapular Y – useful for evaluation of shoulder dislocation
B. Medial oblique elbow
C. AP scapula
D. Lateral oblique elbow - radial head

51.) What position is recommended to demonstrate the ureteropelvic region?

A. Supine C. Lateral
B. Oblique D. Prone

Ballinger 11th Edition Vol. 2 p.218

52.) In Sialography, the patient is given a sour fruit/motor meal before the
procedure starts. Which of the following is/are true regarding this?
1.) To localized the orifice of the selected duct
2.) To stimulate the glands
3.) To evacuate the contrast medium after the procedure
4.) To stimulate secretion of saliva
A. 1 and 3 only C. 1, 2 and 3 only
B. 1, 2 and 4 only D. 1, 2, 3 and 4

53.) Which of the following modifications is used to demonstrate rectosigmoid

colon?
A. Gordon C. Gugliantini
B. Hampton D. Billing

Gordon
 Used to demonstrate the stomach of hypersthenic patient

Gugliantini
 Used to demonstrate the stomach in infant

Hampton
 Best demonstrate the leaf-like pattern of the pylorus and the valve

54.) Best position that demonstrates right colic flexure, ascending and sigmoid
portions of the colon (side down):
A. RPO C. LPO
B. RAO D. LAO

LAO
 Left colic flexure and descending colon (side down)

RPO
 Left colic flexure and descending colon (side up)
LPO
 Right colic flexure, ascending and sigmoid portions of the colon (side up)

55.) With the patient seated at the end of the x-ray table, elbow flexed 80 degrees
and the CR directed 45 degrees laterally from the shoulder to the elbow joint,
which of the following structures will be demonstrated best?
A. Radial head C. Coronoid process
B. Ulnar head D. Olecranon process

56.) Best position that demonstrates left colic flexure and descending colon (side
up):
A. RPO C. LPO
B. RAO D. LAO

57.) Best position that demonstrates the rectum and distal sigmoid portion of the
colon:
A. Right lateral decubitus C. Left lateral decubitus
B. Lateral D. Ventral decubitus

Right lateral decubitus

 Best demonstrates “up” medial side of ascending colon
 Best demonstrates “up” lateral side of descending colon

Left lateral decubitus

 Best demonstrates “up” lateral side of ascending colon
 Best demonstrates “up” medial side of descending colon

Ventral decubitus
 Best demonstrates “up” posterior portion of the colon
 This position is most valuable in double contrast examination
58.) How many degrees of tube angulation are required to open up the high,
horizontal stomach on hypersthenic patient?
A. 35-45o caudad C. 35-45o cephalad
B. 20-25o cephalad D. 20-25o caudad

20-25o cephalad
 Gugliantini
 Demonstrates stomach in infant

59.) This projection demonstrates the stomach infants:

A. Gugliantini C. PA axial
B. AP oblique D. PA oblique – wolf

GUGLIANTINI’S MODIFICATION
PA AXIAL PROJECTION
PP: Prone
RP:
 Sthenic: L2
 Asthenic: 1-2 in. inferior to L2
 Hypersthenic: 1-2 in. superior to L2
CR: 20-25o cephalad
SS:
 Greater and lesser curvature
 Antral portion of the stomach
 Pyloric canal and duodenal bulb
ER: For demonstration of stomach in INFANTS

60.) This method/modification demonstrates the relationship of stomach to

diaphragm and useful in diagnosing hiatal hernia:
A. Gugliantini C. Hampton
B. Poppel D. Wolf

WOLF METHOD
PA OBLIQUE PROJECTION
RAO Position
PP: Prone; RAO 40-45o
 Assume modified knee-chest position: during placement of compression
device
 Compression device placement:
o Horizontally under the abdomen
o Below costal margin
 Barium ingestion: rapid, continuous swallow
 Make exposure during 3rd & 4th swallow:
o Rationale: to allow for complete filling of the esophagus
RP: T6-T7
CR: Perpendicular
 TAKENOTE: the position results in a 10-20o caudad CR angulation
SS: Relationship of stomach to the diaphragm
 Useful in diagnosing hiatal hernia
ER:
 For the purpose of applying greater intraabdominal pressure
 For demonstration of small, sliding gastroesophageal herniation through the
esophageal hiatus

HAMPTON’S MODIFICATION
o
PP: Supine; body 45 towards the side of interest
CR: Perpendicular
SS: Best modification to demonstrate a leaf like pattern of the pylorus and the
valve

POPPEL’S METHOD
SS: Retrogastric space
ER:
 Used to demonstrate right angle view of the stomach
 For evaluation of pancreatic pathology
o Pancreatic mass
o Pancreatic cancer
 o Pancreatitis

61.) This method/modification is valuable in the early diagnosis of ulcerative

colitis, regional colitis and polyps:
A. Robin C. Welin
B. Chassard-lapine D. Billing

ROBIN’S MODIFICATION
-most important modification in BE-
PP: Left lateral position
RP: 2 in. posterior to midaxilliary plane
CR: Perpendicular
SS: Demonstrates direct lateral view of the rectosigmoid colon without
overlapping

CHASSARD-LAPINE METHOD
JACK KNIFE POSITION
AXIAL PROJECTION
Chassard-Lapine: projection is made at almost right angle to the AP projection
 Demonstrates anterior and posterior surfaces of the lower portion of the
bowel
 Permits the coils of the sigmoid to be projected free from overlapping
 Taken:
o Postevacuation radiograph of LI
o Preevacuation radiograph of LI
 Only when patient has reasonably sphincter control
PP: Seated at the edge of table; thigh abducted; IR center to pelvis; lean directly
forward; grasps ankle for support
RP: Lumbosacral region at level of greater trochanter
CR: Perpendicular
SS: Axial projection of the
 Rectum
 Rectosigmoid junction
 Sigmoid

WELIN TECHNIQUE
 Valuable in early diagnosis of:
o Ulcerative colitis
o Regional enteritis
o Polyps
 Air instilled: 1800-2000 cc or more

BILLING’S MODIFICATION
PP: Supine
CR: 35-45o cephalad
SS: Demonstrates rectosigmoid colon
ER: Used to prevent overlapping of loops
62.) Best demonstrates the “up” lateral side of ascending colon and “up” medial
side of descending colon in double contrast examination of the colon:
A. Right Ventral decubitus
B. Left Ventral decubitus
C. Left lateral decubitus
D. Right lateral decubitus

63.) Best demonstrates the “up” posterior portion of the colon:

A. Ventral decubitus position C. Decubitus position
B. Prone position D. Supine position

64.) Best demonstrates the “up” medial side of ascending colon and “up” lateral
side of descending colon double contrast examination of the colon:
A. Right Ventral decubitus
B. Left Ventral decubitus
C. Left lateral decubitus
D. Right lateral decubitus

65.) This is a reverse lindbloom position which is the best projection to separate
the gallbladder shadow from the hepatic flexure or from the iliac crest of asthenic
patient:
A. Gordon’s modification
B. Gugliantini’s modification
C. Fleischner’s modification
D. Billing’s modification

66.) The incumbent chairman of Board of Radiologic Technology:

A. Fortunato Gabon C. Gilberto Palomique
B. Atty. Oscar Romero D. Wilhelmina Gana

Fortunato Gabon
 1st chairman

Atty. Oscar Romero

 Author of Radtech Creed

Gilberto Palomique
 First president of PART

67.) Network of blood capillaries in the walls of the ventricles which serves as the
sites of CSF production:
A. Kiesselbach plexus C. Solar plexus
B. Choroid plexus D. Celiac plexus

Kiesselbach plexus
 Common site of nosebleed

Solar plexus/Celiac plexus

 Vulnerable area to the effects of blow

68.) SA node is located in what part of the heart?

 A. Left Atrium C. Left Ventricle
B. Superior vena caval D. Right Ventricle

Rationale:
 Cardiac excitation normally begins in the sinoatrial (SA) node, located in
the right atrial wall just inferior and lateral to the opening of the superior
vena cava

69.) The aorta receives oxygenated blood from this chamber:

A. Left Atrium C. Left Ventricle
B. Right atrium D. Right Ventricle

70.) What is the major artery that supplies the extremities?

A. Brachiocephalic artery C. Vertebral artery
B. Common carotid artery D. Subclavian artery

Brachiocephalic artery
 Right common carotid artery – supplies right side of the head and neck
 Right subclavian artery – supplies right upper limb

Vertebral artery
 Supplies posterior portion of brain

71.) The right and left coronary arteries branched out from the:
A. Circumflex branch C. Marginal branch
B. Aorta D. Aortic valve

Circumflex branch
 Branched out from left coronary artery

Marginal branch
 Branched out from right coronary artery

Aortic valve
 Valve between the aorta and left ventricle

72.) This artery supplies blood from the heart to all tissues of the body:
A. Pulmonary artery C. Internal carotid artery
B. Vertebral artery D. Aorta

Pulmonary artery
 Only artery that carries deoxygenated blood from heart to lungs

Vertebral artery
 Supplies posterior portion of brain

Internal carotid artery

 Supplies anterior portion of the brain

73.) An arrangement of blood vessels at the base of the brain which equalize the
blood pressure and provide an alternate route for blood to flow:
1. Blood brain barrier
 2. Circle of Willis
3. Cerebral arterial circle
A. 3 only C. 1 and 2 only
B. 1 only D. 2 and 3 only

74.) An important landmark for checking for anatomical atlantooccipital

alignment:
A. Sella turcica C. Dens
B. Foramen magnum D. Clivus

75.) The position of the gallbladder in the hypersthenic patient:

A. High and away from the midline
B. Low and near the midline – asthenic
C. Center on the right upper side of the abdomen – sthenic
D. High and near the midline

76.) The position of the gallbladder in the asthenic patient:

A. Low and near the spine
B. Low and away from the midline
C. Center on the right upper side of the abdomen
D. High and near the midline

77.) In supine position, which of the following structures are filled with air in
double contrast studies of the large intestine:
1. Cecum
2. Ascending colon
3. Transverse colon
4. Descending colon
5. Sigmoid colon
6. Upper rectum
7. Lower rectum
A. 1, 3, 5 and 7 only C. 1, 2, 4 and 5 only
B. 2, 4 and 6 only D. 3, 6 and 7 only

78.) A comminuted fracture of the ring of C1:

A. Jefferson’s fracture C. Hangman’s fracture
B. Compression fracture D. Chance fracture

Jefferson’s Fx
 Comminuted fracture of the ring of C1

Compression fracture
 Fracture that causes compaction of bone & a decrease in length or width
 Wedge-shaped vertebra

Hangman’s fracture
 Fracture of the anterior arch of C2 due to hyperextension

Chance fracture
 Fracture through the vertebral body caused by hyperflexion force
79.) This joint is commonly known as the “yes” joint:
A. Atlantoaxial – “no” joint C. Atlantooccpital
B. Odontoaxial D. Occipitoaxial

80.) 1st CMC joint is an example of:

A. Ball and socket joint C. Gliding joint
B. Saddle joint D. Hinge joint

Ball and socket/Spheroidal joint

 Allows greatest freedom of motion
 Flexion, extension, abduction, circumduction, medial and lateral rotation
 Hip and shoulder joints

Saddle/Sellar joint
 Biaxial movements
 Flexion, extension, adduction, abduction and circumduction
 First CMC joint, ankle joint and calcaneocuboid joint

Gliding/Plane joint
 Permits least movements
 Sliding or gliding movements
 Intermetacarpal, carpometacarpal and intercarpal joints; atlantoaxial joints

Hinge/Ginglymus joint
 Flexion and extension movement
 Interphalangeal and elbow joints

81.) A type of joint with a greatest freedom of movement:

A. Ball and socket joint C. Gliding joint
B. Saddle joint D. Hinge joint

82.) In prone position, which of the following structures are filled with barium in
double contrast studies of the large intestine:
1. Cecum
2. Ascending colon
3. Transverse colon
4. Descending colon
5. Sigmoid colon
6. Upper rectum
7. Lower rectum
A. 1, 3, 5 and 7 only C. 1, 2, 4 and 5 only
B. 2, 4 and 6 only D. 3, 6 and 7 only

83.) The body of an average adult contains how many liters of blood?
A. 5 L C. 6 L
B. 7 L D. 8 L

84.) The average urine output per day:

A. 1 L C. 1.5 L
 B. 2.5 L D. 3 L

85.) A health professional who prepares and sterilizes the instruments before the
surgical procedure is begun:
A. Surgical assistant C. Anesthesiologist
B. Circulator nurse D. Scrub nurse

Surgical assistant
 Assists the surgeon
 Suctioning, tying and clumping blood vessels, cutting and suturing tissue

Circulator nurse
 Responds to the needs of scrubbed members within the sterile field
 Recording pertinent information, retrieval of additionally needed items,
counts opened packages after the surgery

Anesthesiologist
 Administers anesthetic drugs to the patient

86.) A health professional who assists in the OR by responding to the needs of

scrubbed members within the sterile field:
A. Surgical assistant C. Anesthesiologist
B. Circulator nurse D. Scrub nurse

87.) The degree of RF heating is expressed in:

A. Celsius C. SAR
B. RF heat units D. Kelvin

Specific absorption ratio (SAR)

 Expressed RF heating
 Unit: W/kg
 Principal result of the interaction between an RF field and tissue is HEAT

88.) The magnetic field outside the patient aperture:

A. External magnetic field C. Internal magnetic field
B. Fringe magnetic field D. RF magnetic field

89.) Portion of anatomy that includes tumor and adjacent areas of invasion:
1.) Treatment field
2.) Tumor volume
3.) Target volume
4.) Field
A. 1, 2 and 3 only C. 1 and 2 only
B. 2 and 3 only D. 1, 2, 3 and 4

Treatment field
 Anatomic area outlined for treatment

Field
 Geometric area defined by collimation or radiotherapy unit at skin surface
90.) Part of the transducer that is used to compensate for the large differences of
acoustic impedance between the patient and crystals and to improved transmission
of ultrasound beam into the body:
A. Physical housing C. Backing material
B. Damping material D. Matching layer

Impedance Matching Layer

o Sandwich between the piezoelectric crystal and the patient
o Chosen to improved transmission into the body

Physical Housing
 Contains all individual components
 Provides the necessary structural support
 Acts as an electrical and acoustic insulator

Backing/Damping Materials
 Shortens the ultrasound pulse length
 Eliminates the vibrations from the back face
 Controls the length of vibrations from the front face
 Improves axial resolution
 Materials:
o Plastic or epoxy resin
o Cork
o Rubber
o Araldite loaded with tungsten powder

91.) This artifact appears as an area of low amplitude echoes behind an area of
strongly attenuating tissue:
A. Reverberation C. Acoustic shadowing
B. Acoustic enhancement D. Side lobe artifact

Acoustic Shadowing
 Caused by highly attenuating structure
 Often occur at:
o Soft tissue and gas
o Soft tissue and bone or calculus
o Calcified mass

Reverberation
 Comet tail
 The production of spurious or false echoes due to repeated reflections
between two interfaces with a high acoustic impedance mismatch
 The presence of two or more strong reflecting surfaces
 Often occur at:
o Skin-transducer interface
o Gas surface and transducer
 Prevention/Elimination:
o Increase the amount of gel used
 o Used a stand-off gel pad
o Reduce the gain
o Move the position of the transducer

Acoustic Enhancement
 Caused by weakly attenuating structures
 Often occur at:
o Distal to fluid-filled urinary bladder, gallbladder or cyst
o Fluid-filled mass

Side Lobe Artifact

 Echoes generated by side lobes assumed by the transducer to have arisen
form the central axis of the main lobe
 Appearance can give rise to a false diagnosis
 Inherent characteristic of the transducer

92.) This artifact appears as a localized area of increased amplitude behind an area
of low attenuation:
A. Reverberation C. Acoustic shadowing
B. Acoustic enhancement D. Side lobe artifact

93.) The tissue volume is known as:

A. Matrix C. Pixel
B. Hounsfield unit D. Voxel

Matrix
 Layout of cells in rows and columns

CT number/Hounsfield unit
 The numeric information contained in each pixel

Pixel
 A picture element
o Each cell of information
o Two-dimensional
 Pixel Size = FOV ÷ matrix size

Voxel
 A volume element
 The tissue volume
 Voxel (mm3) = pixel size (mm2) x slice thickness (mm)

94.) A two-dimensional representation of a corresponding tissue volume:

A. Matrix C. Pixel
B. Hounsfield unit D. Voxel

95.) Also called spin-spin relaxation time:

A. T1 relaxation time
B. Spin density
C. T2 relaxation time
 D. Longitudinal relaxation time

Spin density
 Determines the hydrogen concentration

96.) Also called spin-lattice relaxation time:

A. T1 relaxation time
B. Spin density
C. T2 relaxation time
D. Transverse relaxation time

97.) Individual collimator rods within the treatment head of the linear accelerator
that can slide inward to shape the radiation field:
A. Asymmetric jaws
B. Independent jaws
C. Multileaf collimator
D. Variable-aperture collimator

Multileaf collimator
 The newest and most complex beam-defining system
 Location: within the head of the linac
 Can be adjusted to shape the radiation field to conform to the target volume

Asymmetric/independent jaws
 Four independent x-ray collimators that are used to define the radiation
treatment field

Variable-aperture collimator
 Most commonly used beam-restricting device in radiography

98.) This is used to achieve wedge-shaped dose distributions by computer-

controlled movement of one of the collimator jaws:
A. Physical wedge C. Step wedge
B. Dynamic wedge D. Compensating wedge

Dynamic wedge
 Achieves wedge-shaped dose distributions by computer-controlled
movement of one of the collimator jaws under simultaneous adjustment of
dose rate

Physical wedge
 The primary means of producing the wedged fields
 Inserted in the treatment head of linear accelerator in four different
orientations (in, out, left and right)

Step wedge
 Adaptation of wedge filter
 Used in some special procedure
o Serial radiography of abdomen and lower extremities

Compensating Wedge
  Commonly used as beam-modifying devices in radiation therapy to optimize
the target volume dose distribution

99.) The bone healing tissue that forms around the broken bone and usually an
essential part of the process of healthy union in a fractured bone:
A. Corns C. Collagen
B. Cartilage D. Callus

Corns
 A painful conical thickening of the stratum corneum of the epidermis found
principally over toe joints and between the toes
 Caused by friction or pressure

Cartilage
 Type of connective tissue
 Shock absorber and reduces friction

Collagen
 Main structural protein of connective tissue

100.) A disease in which a defect in uric acid metabolism causes an excess of the
acid and its salts to accumulate in the bloodstream and the joints:
A. Rheumatoid arthritis C. Gout
B. Degenerative joint disease D. Osteoarthritis

Rheumatoid arthritis
 A chronic inflammatory disease that typically affects the small joints in
hands and feet
 3x more common in women

Osteoarthritis/Degenerative joint disease

 Noninflammatory joint disease
 Characterized by gradual deterioration of the articular cartilage
 Most common type of arthritis
 Normal part of aging process

-THE END-
“DOING your BEST is more important than BEING the BEST”

Prepared by:
Meynard Y. Castro, RRT
License No.: 0011644
06/21/14